Island Chiropractic Center

Organization Active NPI Chiropractor · Chincoteague Island, VA

NPI 1780164947 · NPPES record last updated Aug 17, 2018

Key facts

NPI
1780164947
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
CH9501 (FL)
Legal business name
ISLAND CHIROPRACTIC CENTER
Practice address
6295 Teal LN
Chincoteague Island, VA 23336-2207
Phone
(321) 439-7265
NPI assigned
Aug 17, 2018
Organization subpart
No

Authorized official

Name
Dr. Roden C Stewart, DC
Title
Owner
Phone
(321) 439-7265

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190617003252 VA Part B Supplier - Clinic/Group Practice 3375876717 Receives reassigned benefits from 1 practitioner
Practice locations: Accomac, VA; Chincoteague, VA

National Provider Directory

Locations

22639 Center Pkwy
Accomac, VA 23301
Phone (757) 302-0501

6295 Teal Ln
Chincoteague Island, VA 23336
Phone (757) 336-2200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X CH9501 FL Yes

Addresses

Primary practice location

6295 Teal LN
Chincoteague Island, VA 23336-2207

Mailing address

6500 Leonard LN
Chincoteague Island, VA 23336-1334
Phone (321) 439-7265

Other providers in Chincoteague Island, VA

All providers in Chincoteague Island, VA · Chiropractor in Virginia

Sources for this page

Verify at the official NPI Registry.